population known to have a high prevalence of diabetes may have been due to the fact that pregnant women in Malta are currently not routinely screened for this condition via oral glucose tolerance tests.The association between threatened spontaneous abortion and pregnancy complications can be partly explained by an increase in reactive oxygen species and chronic damage to fetal membranes, which can lead to impaired placentation [1]. Placental oxidative stress is associated with increased necrosis and apoptosis of the villous trophoblast and involvement of cytokines. In the present study, the overall rate of spontaneous abortion in the study group (26.6%) was higher than in studies of other populations (e.g. 9% [1] and 14% [4]). This may have been because of variations in cytokine levels between different ethnic populations living in different environments. Future studies should measure plasma levels of T helper (Th)-1 and Th-2 cytokines in a cohort of Maltese women with threatened spontaneous abortion, and compare them with those of a matched comparable different population.